乳癌診斷確立的剎那，影響的不只是婦女本身，更對家人及其配偶產生強烈的衝擊。近年來國外學者逐漸開始重視在此適應歷程中，家屬照顧者如何去因應以獲得較佳的生活品質，而目前國內之相關研究仍尚待發展。本研究旨在探討在疾病治療過程中且未經歷復發階段的乳癌患者，其家屬照顧者之因應、社會支持與生活品質之相關性。
本研究設計採取橫斷式研究，以結構性問卷於南部兩所醫學中心及一所區域教學醫院之外科門診與化療室收集資料，有效問卷共65份。研究工具包括：家屬因應行為量表、照顧者社會支持量表及台灣簡明版世界衛生組織生活品質問卷。

　　研究結果發現：(1)情緒取向因應與整體生活品質的生理健康、心理、社會關係及環境等四個範疇成顯著負相關；反之，問題取向因應與各範疇成顯著正相關。(2)家屬照顧者主觀認為所獲得的社會支持程度，特別是來自於家人親友的部分，與其生活品質的心理、社會、環境三個範疇成顯著正相關。(3)逐步迴歸分析發現，情緒取向因應、問題取向因應、家庭平均月收入及來自家人親友的社會支持等變項，對家屬照顧者生活品質各範疇皆具有顯著解釋量，可解釋其總變異量的38%~55%；整體而言，以情緒取向因應最為重要，而問題取向因應次之。

　　本研究結果顯示，乳癌此類慢性疾病之家屬照顧者的情緒取向因應越少，問題取向因應越多，且主觀感受到來自家人親友的社會支持較高時，其整體生活品質較佳。藉此可供臨床醫療相關人員，在給予患者及其家屬照顧者適當之衛教方針及健康照護上之參考，並有助於未來後續之研究探討。

Purpose: Coping with breast cancer is a major challenge for patients and their family caregivers. In spite of caregiver’s difficulties, little is known about how they cope with the effects of cancer, and their quality of life. The purpose of this study was to identify factors that affect the adjustment of family caregivers of breast cancer patient and to examine what coping strategies and sources of perceived social support are related to higher quality of life.

Methods: A cross-sectional study was designed to determine the relationship between predictor variables (coping strategies, perceived social support) and their quality of life. The sample consisted of 54 family caregivers of women who had been diagnosed with stage 0-3 of breast cancer within the period of 18-month. The multiple standardized instruments with established reliability and validity were used to measure the study variables. The independent variables were measured with the Family Coping Behaviors Scale, the Social Support Scale. The dependent variable, psychosocial adjustment, was measured with the WHOQOL-BREF.

Results: Bivariate correlational analyses showed that problem-focused coping strategies and social support from family/friends were both significant positively relative to quality of life, whereas emotion-focused coping strategies had detrimental effects. Study variables accounted for a considerable amount of variance in family caregivers’ quality of life (38%~55%). In these factors, emotion-focused coping and problem-focused coping accounted most variance in level of quality of life of family caregivers.

Conclusion: The findings suggest that coping strategies are very influential in family caregivers to deal with the effects of cancer, and the perceived adequacy of support from family members or friends is also important about their psychosocial adjustment. Programs need to include family members to help counteract the negative effects of the disease on their mental health, and enable them to continue as effective caregivers.

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